Two‐dimensional and three‐dimensional sonography of conjoined twins

Bonilla‐Musoles, Fernando; Machado, Luiz Eduardo; Osborne, Newton G.; Blanes, Javier Silvestre; Bonilla, Francisco; Raga, Francisco; Machado, Fernanda de Souza

doi:10.1002/jcu.10035

Cited by 19 publications

(14 citation statements)

References 18 publications

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“…Recently it has become possible to assess conjoined fetuses by three dimensional echocardiography, and this may be helpful for the parents, as the images are easier to understand. 20 Magnetic resonance imaging has an increasing role in multisystem evaluation of conjoined twins before separation and has the advantage of being able to produce three dimensional reconstructed images in any orientation as well as providing information about intracardiac and great vessel blood flow. [21][22][23] Multislice computed tomography with its rapid acquisition times may also be useful, particularly in assessing details of arterial and venous anatomy.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic assessment of conjoined twins

Andrews

McMahon²,

Yates³

et al. 2005

Heart

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Objective: To determine the accuracy of prenatal and postnatal echocardiography in delineating the degree of cardiac fusion, intracardiac anatomy (ICA), and ventricular function of 23 sets of conjoined twins with thoracic level fusion presenting to a single centre over a 20 year period. Methods: 13 thoracopagus, 5 thoraco-omphalopagus, and 5 parapagus pairs presenting to the authors' institution between 1985 and 2004 inclusive were assessed. Echocardiographic data were analysed together with operative intervention and outcome. Twins were classified according to the degree of cardiac fusion: separate hearts and pericardium (group A, n = 5), separate hearts and common pericardium (group B, n = 7), fused atria and separate ventricles (group C, n = 2), and fused atria and ventricles (group D, n = 9). Results: The degree of cardiac fusion was correctly diagnosed in all but one set. ICA was correctly diagnosed in all cases, although the antenatal diagnosis was revised postnatally in three cases. Abnormal ICA was found in one twin only in two group A pairs, one group B pair, and both group C pairs. All group D twins had abnormal anatomy. Ventricular function was good in all twins scanned prenatally, and postnatally function correlated well with clinical condition. Thirteen sets of twins in groups A-C were surgically separated; 16 of 26 survived. None from groups C or D survived. Conclusions: Prenatal and postnatal echocardiography accurately delineates cardiac fusion, ICA, and ventricular function in the majority of twins with thoracic level fusion. It is integral in assessing feasibility of separation. The outcome in twins with fused hearts remains dismal.

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Section: Discussionmentioning

confidence: 99%

Echocardiographic assessment of conjoined twins

Andrews

McMahon²,

Yates³

et al. 2005

Heart

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“…Three-dimensional ultrasound adds information about the linking areas and surface abnormalities but is not necessary for definitive diagnosis of conjoining. 19 This case reviews the imaging findings in a very rare fetal anomaly. With such rare cases, it is important to try to learn as much as possible from each case.…”

Section: Discussionmentioning

confidence: 95%

Ultrasound diagnosis of dicephalic conjoined twins at 24 weeks of gestation

Sabih

Worrall³

et al. 2009

J of Clinical Ultrasound

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We report the case of dicephalic conjoined twins discovered incidentally on a routine ultrasound at 24 weeks of gestation. There were 2 heads and a neck that fused with 1 thorax, but the spines continued all the way to the coccyx. The spines were connected medially by a fused rib, and laterally, there were ribs that went around the thorax in a more normal fashion. Antenatal ultrasound images are supplemented by postnatal photographs and x-rays.

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“…4 Although the diagnosis of conjoined twins can frequently be made at midpregnancy using two dimensional and, more recently, three-dimensional sonography, 5 cases have been reported in the literature that were diagnosed either by transvaginal ultrasonography or three-dimensional sonography in the first trimester. 6,7 Parapagus twins represent an extremely rare type of conjoined twins, and there is little information in the literature.…”

Section: Discussionmentioning

confidence: 98%